After Jitahadi spent a few weeks on medication, her vision cleared and she began to feel better. It didn't last long. "I hated metformin. I had all the colon and digestive issues on it," she says. "I never knew if I would be OK on it or if I'd be nauseous. I'd question whether I wanted to go out with my friends." When she asked for an alternative medication, her doctor said metformin was the best drug for the job, so Jitahadi stuck it out for a year. After that, she decided to make major lifestyle changes in hopes of quitting her medications.
Serious urinary tract infections (UTI), some that lead to hospitalization, occurred in people taking FARXIGA. Tell your doctor if you have any signs or symptoms of UTI including a burning feeling when passing urine, a need to urinate often, the need to urinate right away, pain in the lower part of your stomach (pelvis), or blood in the urine with or without fever, back pain, nausea, or vomiting
I recommend for my patients to eat a variety of foods when managing Diabetes Type 2 with diet. I particularly encourage patients to include protein from a variety of sources, fiber, and vegetables or fruit with each meal. Including small portions of many food groups with each meal ensures that patients’ bodies are being healthfully fueled and they will often feel more satisfied with their meals preventing overeating and grazing throughout the day.

As a renal dietitian my focus can’t be solely on diabetes. Although a very large percentage of our patients with chronic kidney disease are here due to unmanaged blood sugar control, that is just one of our problems. I have to prioritize my counseling in other ways – the most important being control of potassium, then sodium (fluid), protein and phosphorus.
A ketogenic diet for prediabetes might include about 20 to 50 grams per day of non-fiber carbohydrates, or about 5 to 10% of total calories from carbohydrates. The rest of your calories come from fat and protein. The food choices on this diet are similar to those on other low-carb diets, but you may need to further restrict some of the moderate-carbohydrate options that might be easier to fit in on a more moderate low-carb diet. Examples include fruit (an apple has 24 grams of non-fiber carbohydrates) and starchy vegetables (a half-cup of corn has 15 grams of non-fiber carbs).
Food sources of carbohydrates including breads, cereals, crackers, pasta, starchy vegetables (peas, corn, potatoes), fruit and sweets/desserts need to be eaten consistently throughout the day by focusing on small and frequent meals every 3-4 hours. Patients with type 2 diabetes should work with a dietitian who can prescribe a goal number of carbohydrate servings (or grams) at each meal and snack and teach appropriate portion size for each carbohydrate food. Daily carbohydrate needs will vary based on the individual.
If you choose to drink alcohol, remember: To drink with your meal or snack (not on an empty stomach!), to drink slowly or dilute with water or diet soda, that liqueurs, sweet wines and dessert wines have a lot of sugar, to wear your Medic Alert (Alcohol can cause hypoglycemia/low blood glucose), reducing alcohol can promote weight loss and help you lower your blood pressure.

Thiazolidinediones. Like metformin, these medications — including rosiglitazone (Avandia) and pioglitazone (Actos) — make the body's tissues more sensitive to insulin. These drugs have been linked to weight gain and other more-serious side effects, such as an increased risk of heart failure and anemia. Because of these risks, these medications generally aren't first-choice treatments.


Up your soluble fiber intake: There are two types of fiber – the type that does not dissolve in water (insoluble fiber) and the kind that does (soluble fiber). Insoluble fiber can help manage weight and prevent constipation by moving quickly through the digestive tract and adding bulk to stool. Soluble fiber, on the other hand, absorbs water and turns into a gel-like consistency during digestion. This process slows down digestion and nutrient absorption. Soluble fiber can also lower blood sugar and cholesterol levels: because it isn’t well absorbed, it doesn’t contribute to blood sugar spikes and can help manage type 2 diabetes.
You may feel fine, but that is no guarantee that your blood sugar levels are in the target range. Remember, diabetic complications do not appear right away. And complications may develop even when the blood sugar is only slightly elevated. Regular blood sugar monitoring can help you keep your blood sugars in control and prevent serious damage to your eyes, kidneys and nerves. If your sugar levels are out of line, consult your doctor.
To avoid fast food, a convenient temptation, he prepped meals in advance. "A lot of it, especially as I lost a lot of weight, had to do with saying, 'I just walked x miles and burned x calories, do I really want to ruin it by popping in and having a burger?' " he says. "After a while, it got a little easier. Now I drive by [fast-food restaurants] and I don't even give them a second thought."

Absolutely. We can beat diabetes. The disease process associated with diabetes (which leads to heart attacks, strokes, and other crippling illnesses) can be slowed and even partially reversed by controlling blood glucose and other cardiovascular disease risk factors. For maximum effectiveness, blood glucose must be controlled at near normal levels throughout most of the day via loss of excess weight, particularly belly fat, as well as daily physical activity, and, if necessary, medications and insulin injections.
Long bouts of hot, sweaty exercise aren’t necessary to reap this benefit. Findings from the Nurses’ Health Study and Health Professionals Follow-up Study suggest that walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30 percent. (18, 19) More recently, The Black Women’s Health Study reported similar diabetes-prevention benefits for brisk walking of more than 5 hours per week. (20) This amount of exercise has a variety of other benefits as well. And even greater cardiovascular and other advantages can be attained by more, and more intense, exercise.
The oral glucose tolerance test (OGTT), or glucose tolerance test is a blood test used (not routinely however) to diagnose diabetes, and gestational diabetes. Information in regard to reliability of the oral glucose tolerance test is important, as some conditions (common cold), or food (caffeine), or lifestyle habits (smoking) may alter the results of the oral glucose tolerance test.
Metformin is likely effective for as long as 10 years, based on long-term follow-up of patients in the Diabetes Prevention Program (DPP). In this trial, investigators randomized 3234 at-risk patients to 3 groups: metformin 850 mg twice daily; lifestyle modification (7% weight loss, 150 minutes of physical activity per week, and a one-to-one 16-lesson curriculum covering diet, exercise, and behavior modification); or placebo.4 At a mean 2.8-year follow-up, the incidence of diabetes was 31% lower in the metformin group (95% confidence interval [CI], 17%-43%) and 58% lower in the lifestyle modification group than in the placebo group (95% CI, 48%-66%; P<.001 for both comparisons).
When overweight diabetic patients drop some weight by trimming down ‘serving sizes’ and calories, insulin sensitivity improves, thereby optimizing drug therapy. The fundamental principle behind maintenance of body weight is the energy balance. This group should be encouraged to maintain their current weight by: Maintaining current ‘serving sizes,’ eating about the same amount of food each day, eating at about the same times each day, taking their drugs at the same times each day, and exercising at the same times each day. These patients should also endeavor to choose their daily foods from starches, vegetables, fruits, and protein, while limiting the amount of fats.[41,42,43,44,45]

Type-2 diabetes is a major, non-communicable disease with increasing prevalence at a global level. Type-2 diabetes results when the body does not make enough insulin or the body cannot use the insulin it produces. Type-2 diabetes is the leading cause of premature deaths. Improperly managed, it can lead to a number of health issues, including heart diseases, stroke, kidney disease, blindness, nerve damage, leg and foot amputations, and death. Type-2 diabetes or adult-onset diabetes is most common type of diabetes, usually begins when a person is in his or her mid-50s, but diabetes is not inevitable. Minor changes in your lifestyle can greatly reduce your chances of getting this disease. Therefore, in order to prevent this condition, action should be taken regarding the modifiable factors that influence its development-lifestyle and dietary habits. However, with proper testing, treatment and lifestyle changes, healthy eating as a strategy, promote walking, exercise, and other physical activities have beneficial effects on human health and prevention or treatment of diabetes, promoting adherence to this pattern is of considerable public health importance.

The process of type 2 diabetes begins years or even decades before the diagnosis of diabetes, with insulin resistance. Insulin resistance is the beginning of the body not dealing well with sugar, which is the breakdown product of all carbohydrates. Insulin tells certain body cells to open up and store glucose as fat. When the cells stop responding your blood sugar rises, which triggers the release of more insulin in a vicious cycle. Insulin resistance is associated with abdominal obesity, high blood pressure, high triglycerides, and low HDL ("good cholesterol"). When these occur together, it is known as metabolic syndrome or pre-diabetes. It is a risk factor for heart disease and type 2 diabetes.
As a bonus, stress relief may help you sleep better, which is important because studies show that not getting enough sleep can worsen type 2 diabetes. Sleeping less than six hours a night has also been found to contribute to impaired glucose tolerance, a condition that often precedes type 2 diabetes. In fact, a review published in 2015 in Diabetes Care analyzed 10 studies that involved more than 18,000 participants combined and found the lowest risk of type 2 diabetes in the group of participants that slept seven to eight hours per day. That’s the minimum recommended amount of sleep for most adults, according to the National Sleep Foundation.

There are a few methods that can be used for diabetic meal planning. It is good to research more than one, but also important to remember that diabetic diet needs are going to vary based on your sex, age, activity level, medications, height, and weight. If you have not yet met with a registered dietitian, seek one out who can help you develop an individualized meal plan that will meet all of your specific needs.


Consider signing up for a virtual coach.  Trying to make these changes on your own, at your own pace, and in your own time is very hard. So consider joining a support group like Overeaters Anonymous so you don't have to go it alone. Another way to gain insights and get some help as you attempt to make some changes is to find an app that offers personalized tips and ideas. Having a virtual coach is both convenient has been shown effective in improving diabetes care.
Prediabetes means a person's blood glucose (sugar) level is higher than normal, but not high enough yet to be diagnosed as diabetes. If you have prediabetes, you are at increased risk for developing serious health problems such as type 2 diabetes, stroke and heart disease. The sooner people find out they have prediabetes and take action, the better their chances of preventing type 2 diabetes.
While there is still no cure for diabetes, there is good news; the progression from prediabetes to diabetes is not inevitable. The National Institutes of Health clinical trial, the Diabetes Prevention Program, found that for people with prediabetes modest lifestyle changes led to weight loss of 5 to 7 percent in participants and can reduce the risk of type 2 diabetes by 58% in individuals at high risk.
Chong points to previous research in Circulation that describes the underlying mechanisms of sleep apnea. In people with sleep apnea, activation of the sympathetic nervous system — including increased heart rate, increased blood pressure, and constriction of blood vessels — all led to a higher risk of heart attack and stroke, which can be compounded in people who have type 2 diabetes (and thus already have a higher risk of heart disease).
Elevated blood sugar can also come from the body’s response to inflammation. If you feel like you’re eating right but can’t figure out why your blood sugar is spiking, it may be due to a food sensitivity. The diarrhea you thought was a side effect of your medication may actually be a food sensitivity. Food sensitivities can also be the root cause of headaches, arthritis, heartburn, fibromyalgia, sinus problems, and more. The stress of these ailments has the potential to elevate blood sugars.
But just as with grains, it’s important to roll out your carb-counting skills when noshing on nature’s candy. The ADA notes that a small piece of whole fruit or ½ cup of canned fruit in natural juices or frozen fruit typically contains 15 g of carbs, while fruit juice — a less ideal source of fruit for diabetes — can have that much in 1/3 to ½ cup.
The glycemic index identifies foods that increase blood sugar rapidly. This handy tool allows you to favor foods that have much less effect on blood sugar. High-glycemic-index foods include sugar itself, white potatoes, most wheat flour products, and most cold cereals, e.g., pumpernickel, rye, multigrain, or sourdough bread, old-fashioned oatmeal, bran cereals, grape-nuts, most fruits, sweet potatoes, pasta, rice, barley, couscous, beans, peas, lentils, most vegetables [Table 1].
The health benefits of a low-fat vegetarian diet such as portions of vegetables, grains, fruits, and legumes (excluding animal products) in people with type-2 diabetes. The vegan diet is based on American Diabetes Association (ADA) guidelines; the results of this study were astounding: Forty-three percent of the vegan group reduced their diabetes medications. Among those participants who didn't change their lipid-lowering medications, the vegan group also had more substantial decreases in their total and LDL cholesterol levels.
That proved more difficult than she had imagined. She hadn't seen a diabetes educator. The only dietitian covered by her insurer was too far away. And her doctor's sole advice was for Jitahadi to watch what she ate. "I was scared in the beginning," says Jitahadi. "It was through friends and starting to read [about diabetes] that I knew I could do this. I could get through this."

Some easy-to-follow examples I often provide are adding chopped mixed vegetables to scrambled eggs and including fresh fruit on the side; preparing a green smoothie with low-fat milk, low-fat yogurt, chopped fresh kale, and frozen fruit; preparing vegetarian jambalaya with brown rice; or choosing a hearty salad with mixed greens, nuts, beans, and light salad dressing from a salad bar. Food can be medicine and it can also be enjoyable!
Elevated blood sugar can also come from the body’s response to inflammation. If you feel like you’re eating right but can’t figure out why your blood sugar is spiking, it may be due to a food sensitivity. The diarrhea you thought was a side effect of your medication may actually be a food sensitivity. Food sensitivities can also be the root cause of headaches, arthritis, heartburn, fibromyalgia, sinus problems, and more. The stress of these ailments has the potential to elevate blood sugars.
Diabetes is a disease that affects how the body uses glucose, the main type of sugar in the blood. Glucose, which comes from the foods we eat, is the major source of energy needed to fuel the body. To use glucose, the body needs the hormone insulin. But in people with diabetes, the body either can't make insulin or the insulin doesn't work in the body like it should.
In contrast, white bread, white rice, mashed potatoes, donuts, bagels, and many breakfast cereals have what’s called a high glycemic index and glycemic load. That means they cause sustained spikes in blood sugar and insulin levels, which in turn may lead to increased diabetes risk. (22) In China, for example, where white rice is a staple, the Shanghai Women’s Health Study found that women whose diets had the highest glycemic index had a 21 percent higher risk of developing type 2 diabetes, compared to women whose diets had the lowest glycemic index. (23) Similar findings were reported in the Black Women’s Health Study. (24)
Protein provides slow steady energy with relatively little effect on blood sugar. Protein, especially plant-based protein, should always be part of a meal or snack. Protein not only keeps blood sugar stable, but it also helps with sugar cravings and feeling full after eating (satiety). Protein can come from both animal or plant sources; however, animal sources are also often sources of unhealthy saturated fats.
The review of various studies suggests that T2DM patients require reinforcement of DM education including dietary management through stakeholders (health-care providers, health facilities, etc.) to encourage them to understand the disease management better, for more appropriate self-care and better quality of life. The overall purpose of treating T2DM is to help the patients from developing early end-organ complications which can be achieved through proper dietary management. The success of dietary management requires that the health professionals should have an orientation about the cultural beliefs, thoughts, family, and communal networks of the patients. As diabetes is a disease which continues for the lifetime, proper therapy methods with special emphasis on diet should be given by the healthcare providers in a way to control the disease, reduce the symptoms, and prevent the appearance of the complications. The patients should also have good knowledge about the disease and diet, for this purpose, the health-care providers must inform the patients to make changes in their nutritional habits and food preparations. Active and effective dietary education may prevent the onset of diabetes and its complications.

Imagine that you hide your kitchen garbage under the rug instead throwing it outside in the trash. You can’t see it, so you can pretend your house is clean. When there’s no more room underneath the rug, you throw the garbage into your bedroom, and bathroom, too. Anywhere where you don’t have to see it. Eventually, it begins to smell. Really, really bad.
Type 2 diabetes is often treated with oral medication because many people with this type of diabetes make some insulin on their own. The pills people take to control type 2 diabetes do not contain insulin. Instead, medications such as metformin, sulfonylureas, alpha-glucosidase inhibitors and many others are used to make the insulin that the body still produces more effective.
The review of various studies suggests that T2DM patients require reinforcement of DM education including dietary management through stakeholders (health-care providers, health facilities, etc.) to encourage them to understand the disease management better, for more appropriate self-care and better quality of life. The overall purpose of treating T2DM is to help the patients from developing early end-organ complications which can be achieved through proper dietary management. The success of dietary management requires that the health professionals should have an orientation about the cultural beliefs, thoughts, family, and communal networks of the patients. As diabetes is a disease which continues for the lifetime, proper therapy methods with special emphasis on diet should be given by the healthcare providers in a way to control the disease, reduce the symptoms, and prevent the appearance of the complications. The patients should also have good knowledge about the disease and diet, for this purpose, the health-care providers must inform the patients to make changes in their nutritional habits and food preparations. Active and effective dietary education may prevent the onset of diabetes and its complications.
Losing weight can lower your blood sugar levels. Losing just 5 to 10 percent of your body weight can make a difference, although a sustained weight loss of 7 percent or more of your initial weight seems to be ideal. That means someone who weighs 180 pounds (82 kilograms) would need to lose a little less than 13 pounds (5.9 kilograms) to make an impact on blood sugar levels.

Research has found, too, that the Pritikin Program can actually reverse the Metabolic Syndrome. In 50% of adult Americans studied, the Pritikin Program reversed the clinical diagnosis of Metabolic Syndrome, and in just three weeks. In research following children with the Metabolic Syndrome, 100% no longer had the syndrome within two weeks of starting the Pritikin Program.
Up your soluble fiber intake: There are two types of fiber – the type that does not dissolve in water (insoluble fiber) and the kind that does (soluble fiber). Insoluble fiber can help manage weight and prevent constipation by moving quickly through the digestive tract and adding bulk to stool. Soluble fiber, on the other hand, absorbs water and turns into a gel-like consistency during digestion. This process slows down digestion and nutrient absorption. Soluble fiber can also lower blood sugar and cholesterol levels: because it isn’t well absorbed, it doesn’t contribute to blood sugar spikes and can help manage type 2 diabetes.

You may be able to manage your type 2 diabetes with healthy eating and being active, or your doctor may prescribe insulin, other injectable medications, or oral diabetes medicines to help control your blood sugar and avoid complications. You’ll still need to eat healthy and be active if you take insulin or other medicines. It’s also important to keep your blood pressure and cholesterol under control and get necessary screening tests.
American Diabetes Association has defined self-dietary management as the key step in providing the diabetics, the knowledge and skill in relation with treatment, nutritional aspects, medications and complications. A study showed that the dietary knowledge of the targeted group who were at high risk of developing T2DM was poor. Red meat and fried food were consumed more by males as compared to females. The percent of males to females in daily rice consumption was significantly high.44
Of course, carbohydrate types, amounts and frequencies still matter. Setting up a routine is best so the body can become more regulated, and medications can be more easily adjusted with medical guidance. For example, a “consistent carbohydrate diet” may include 4-5 carbohydrate servings (60-75 grams) per meal, with 3 meals spaced 4 or 5 hours apart. The inclusion of an evening snack may be recommended pending morning glucose trends. If morning sugars are running under 70 mg/dl, it may be a wise choice to have a 2-carbohydrate evening snack about 1 hour prior to retiring to bed.
The plate method. The American Diabetes Association offers a simple seven-step method of meal planning. In essence, it focuses on eating more vegetables. When preparing your plate, fill one-half of it with nonstarchy vegetables, such as spinach, carrots and tomatoes. Fill one-quarter with a protein, such as tuna or lean pork. Fill the last quarter with a whole-grain item or starchy food. Add a serving of fruit or dairy and a drink of water or unsweetened tea or coffee.
Yeast infection of skin around the penis (balanitis) in men who take FARXIGA. Talk to your healthcare provider if you experience redness, itching, or swelling of the penis; rash of the penis; foul smelling discharge from the penis; or pain in the skin around penis. Certain uncircumcised men may have swelling of the penis that makes it difficult to pull back the skin around the tip of the penis
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